# GLENN STALL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1841268208
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 9801510 | NC | Yes |

## Other

- **Enumeration date:** 03/10/2006
- **Last updated:** 08/25/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 126WG | BCBS | NC |
| 01 | — | 460003102 | MCR RR | NC |
| 05 | — | 89126WG | — | NC |
| 01 | — | P00629153 | RR MEDICARE | NC |